Severe polymyalgia-like symptoms secondary to anti-PD1 therapy successfully managed without discontinuing checkpoint inhibitor.

After reading the article from Braaten et al ,1 we reinforce our idea that suspending checkpoint inhibitors (CPI) due to musculoskeletal symptoms, even if severe, may not always be a good alternative, since in addition to losing an option in the treatment of cancer we do not know if the symptoms will actually resolve with treatment interruption. Here we present a patient who developed severe polymyalgia rheumatic-like (PMR) symptoms 7 months after initiation of nivolumab for metastatic melanoma. Since it was a grade 3 immune-related adverse event according to the guidelines published in the Journal of Clinical Oncology ,2 the oncologist initiated high-dose prednisone and opioids, considered interrupting the …